Systems and methods for frameless image-guided biopsy and therapeutic intervention

Abstract

A system and a method of performing a frameless image-guided biopsy uses imaging, a six-dimensional robotic couch system, a laser guidance system, an optical distance indicator, and a needle control apparatus. A planning CT scan is made of the patient with stereotactic fiduciary markers to localize and produce digitally reconstructed radiographs. Two stereoscopic images are generated using an imaging device to visualize and identify a target tumor. The images are fused with the digitally reconstructed radiographs of the planning CT scan to process tumor location. The tumor location data are communicated to the movable robotic couch to position the target tumor of the patient at a known isocenter location. A biopsy needle is guided with a laser alignment mechanism towards the isocenter at the determined depth using a needle positioning apparatus and an Optical Distance Indicator, and a biopsy sample of the target tumor is obtained.

Description

INCORPORATION BY REFERENCE TO RELATED APPLICATIONS[0001]This application claims the priority benefit of U.S. Provisional Application Ser. No. 61 / 280,176, filed on Oct. 31, 2009, the entirety of which is hereby incorporated by reference herein. Any and all priority claims identified in the Application Data Sheet, or any correction thereto, are hereby incorporated by reference under 37 CFR 1.57.BACKGROUND[0002]1. Field of the Invention[0003]The present application relates to devices and methods for frameless image-guided biopsy and / or therapeutic intervention. In particular, the present application relates to devices and methods for frameless image-guided stereotactic, CT, and / or MRI system biopsy, therapeutic intervention and / or drug delivery for tumors using stereoscopic imaging, laser guidance, and / or infrared-based positioning and tracking of patients, utilizing, for example, a six-dimensional (6D) robotic couch system.[0004]2. Description of the Related Art[0005]Medical treatment...

AI Technical Summary

Benefits of technology

The system achieves precise needle placement within 1 mm, minimizing patient discomfort and complications, and offers greater surgical flexibility with lower complication rates and reduced radiation exposure compared to traditional methods.

Problems solved by technology

Traditional systems and methods for collection of a biopsy sample can be complicated, cumbersome, and may be overly invasive to the patient.

However, frame-based head fixation can be painful and the head movement limitation can be intolerable to many patients.

Furthermore, there is risk of epidural hematoma, cranial fracture, and cerebrospinal fluid (CSF) leak following the application of head pins, and laceration of the scalp with patient movement especially in young children.

From the surgeon's perspective, rigid head fixation can also be problematic since the head pins are bulky and limit intraoperative flexibility as well as free movement of surgical instruments.

If the patient's head moves relative to a reference arc, the accuracy of the system is greatly reduced, potentially compromising successful execution of the procedure.

CT Guided biopsy can be challenging at times because the patient has to be moved out of the CT gantry to place the needle, thus lowering the precision and causing the high false-negative rate of 11% to 24% for lytic and sclerotic lesions, respectively, and low diagnostic accuracy of 76%.

Furthermore, current systems typically do not utilize image fusion that can help delineate the tumor by using high soft tissue contrast imaging provided by MRI, or high metabolic tumor activities information that can be provided by PET scans.

Another disadvantage of the CT-guidance is high ionizing radiation exposure to the patient or the interventional radiologist since the patient has to be scanned before, during, and maybe after the needle placement.

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